Early breast cancer poses heavy financial toll on Korean women in 40s, 50s: study

The average economic loss of early-stage breast cancer patients in Korea is more than 70 million won ($51,594), according to a new study. In the case of recurrence, the losses rose to 88.13 million won, and the economic losses increased with higher stages and lower quality of life.

On Thursday, the Sogang Health Communication Center released the results of a review study sponsored by Novartis Korea on “Social Burden and Economic Loss of Early Breast Cancer Patients.”

The research team, led by Professor Yoo Hyun-jae of the Sogang Health Communication Center, conducted the study to systematically analyze the social, economic, and emotional difficulties experienced by early-stage breast cancer patients, who account for about 90 percent of breast cancer patients in Korea. The study used a combination of surveys and expert consultations.

Average economic loss per early-stage breast cancer patient is over 70 million won

In Korea, breast cancer is an aggressive cancer that primarily affects women in their 40s and 50s who are economically active and play a central role in the family. Patients bear the overlapping burden of treatment, career interruption, and family responsibilities. In the study, 77.4 percent of the early breast cancer patients surveyed were women in their 40s and 60s, 73.3 percent had children, and 68 percent lived in households of three or more people.

The study found that the average cost of economic losses for early breast cancer patients ranged from a minimum of 38.97 million won to a maximum of 75.07 million won.

The economic loss was defined as the cost borne by early breast cancer patients which included direct medical expenses and indirect costs, including lost income due to work interruptions, lost household labor, childcare, transportation, and caregiving expenses. It was based on the cumulative total cost of each patient's treatment, ranging from less than six months (minimum duration) to more than three years (maximum duration).

Regarding the medical factors associated with economic costs, the study found that patients with early-stage breast cancer who experienced a recurrence had higher overall economic losses. Patients with early-stage breast cancer who experienced a recurrence had an average of about 29 million won more economic loss costs than those who did not experience a recurrence.

In particular, the recurrence group spent about 13.3 million won more in indirect costs, including lost productivity and household labor compared to the non-recurrence group. This means that the indirect costs of relapsed patients were about 1.8 times higher than those of non-relapsed patients.

As the study only looked at patients with early-stage breast cancer (stages 1-3), the researchers expect the socioeconomic costs of breast cancer recurrence to be even higher when considering metastatic breast cancer, including stages 1-4.

The cost of economic losses also varied by the stage of breast cancer at first diagnosis (stage 1, 2, or 3): the higher the stage, the higher the direct medical costs, as well as the significantly higher indirect costs.

Patients diagnosed with stage 3 incurred about 24 million won more indirect costs than those diagnosed with stage 1 and 19 million more than those diagnosed with stage 2. In other words, the difference in total economic losses (direct medical costs + indirect costs) between patients diagnosed with stage 1 and stage 3 was about 39.22 million won on average, indicating that the higher the stage, the higher the cost.

About 75% of early breast cancer patients are concerned about recurrence

In response to the question “Are you worried about recurrence?”, one of the questions measuring fear of recurrence and treatment, 76.7 percent expressed concern about recurrence, including 40.7 percent who answered, “Very much so.”

When quality of life was divided into three groups based on the mean, the majority (58.7 percent) were self-described as having a low quality of life (low group), followed by medium (25.3 percent) and high (16 percent) groups.

When looking at the relationship between quality of life and economic costs, it was found that patients with low quality of life incurred higher indirect costs than those with high quality of life, averaging about 10.62 million won over the course of treatment.

The researchers interpreted this as a result of productivity losses due to the limited ability to combine treatment and work due to jobs that do not allow for leave or flexible work and increased indirect expenses, including household expenses, due to the lack of a care system or emotional support base within the family.

“Unlike overseas, where the main age group for breast cancer is in the 60s and 70s, breast cancer in Korea is predominantly diagnosed in women in their 40s and 50s, who play a pivotal role in economic activities and family upbringing and care, and recurrence affects not only the patient but also the family and society as a whole,” said Professor Park Yeon-hee of the Department of Hematology-Oncology at Samsung Medical Center, who advised the study.

Professor Yoo, who led the study, said, “In addition to the direct medical expenditures of early-stage breast cancer patients, the study also identified indirect impacts such as lost income from interrupted careers and the value of lost household labor for homemakers, which are often overlooked.”

In particular, recurrence is a mechanism that amplifies both emotional and economic impacts. There is a consensus among medical experts that it should be viewed as a complex problem, as it can lead to mental health issues such as isolation, depression, and low self-esteem, in addition to interrupted careers and difficulty fulfilling domestic roles, Professor Yoo added.